Neuro Diseases and Conditions

Question 1

Amyotrophic lateral sclerosis (ALS)

Answer 1

Progressive motoneuron disease

Presents with moderate weakness in affected limb, leads to death from severe paralysis that involves respiratory system

Question 2

Parkinson’s Disease

Answer 2

Loss of dopaminergic neuronal function then loss of these neurons in the substantia nigra

Question 3

Multiple Sclerosis (MS)

Answer 3

Quintessential CNS demyelinating disease

Autoimmune

Infiltration of T cells and macrophages and plaques of astrocytic aggregations

T cells secrete Fas ligand which binds oligodendrocytes and induces apoptosis

Macrophages strip myelin from axons

Axons are spared but their function is severely compromised (AP conduction blocked or much slower)

Question 4

What can cause elevated CK?

Answer 4

Inflammatory and inherited myopathies

Question 5

Proximal vs. distal muscle weakness

Answer 5

Proximal muscle weakness more common in muscle disease (except myotonic dystrophy)

Distal muscle weakness more characteristic of neuropathies

Question 6

Botulism

Answer 6

Caused usually by contaminated food

Descending weakness

Typically involves bulbar muscles (cranial nerve stuff! Ptosis, palate weakness, impairement of swallowing)

No diarrhea

Can have incremental increase in amplitude of CMAP with repetitive stimulation

Question 7

Lambert-Eaton Syndrome

Answer 7

Antibodies against presynaptic voltage-gated Ca2+ channels (P/Q type)

Increased CMAP on repetitive nerve stimulation because a little Ca2+ gets out each time, making contraction stronger each time

Leg weakness, NO ptosis, small cell carcinoma of lung